1976, 02-02 Permit App: L2535 MHIII) Iii0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT do
+ GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kind or alter any building or structure already erected, or to change a land use. Construction must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
// APPLICANT FILL IN BELOW THIS LINE
Name of Owner r%Li a y ./�, t) i� iv) < r Address �� 11 - �/�''�f Phone 1 U'
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description of Pro erty (Give complete de cription from dee tax receipt, e I
C
DESCRIPTION OF WORK: New x Addition Remodel Moving Bld Zone / Fire Zone 3
Sewage System /� Const.
�f (Fr., Conc., Br., etc.)
Stories / Dimensions /D Y _5-5_ 1 Total Sq. Ft —3 -57) Valuation r� c`'i7C'
pours _=_ Baths / Basement fort{- Foundation Const 13 he <I_ Chimney Fireplace
(Full, part, none (Kind) (Number
Heat. System C Typ of Roofing AX /1/ t. Finish Int. Wall Finish
Use of Bldg. di /19C , 1.. •-/ i6'.S`ler/-'lii'C C- No. of Units _ Bedrooms -�
Size of Lot
77 V/3---
RJLiicettiti
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
1
NORTH
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify,- 1n rmation submitted is correct and there are no other structures located on this property except
as. shown.
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(51 -Art, -.)11W- DO NOT WRITE BELOWTHIS LINE
Your street address will be / J /, ZX'/ -"X/ The zone is._7. N
Sewage Permit Number , Issued Building/Permit %75 Receipt Issued
Remarks
Form 523 Bldg. Code
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